{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T12:34:30Z","timestamp":1793018070405,"version":"4.5.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the clinical efficacy of subthreshold micropulse laser (SML) combined with anti-VEGF drugs versus anti-VEGF drugs monotherapy for diabetic macular edema (DME) through a meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically reviewed relevant literature from electronic databases and extracted key outcomes, including best corrected visual acuity (BCVA)\u2014comprising ETDRS and LogMAR measures, central macular thickness (CMT), annual frequency of anti-VEGF injections, annual SML applications, and associated complications for both treatment groups at postoperative intervals of 3, 6, 9, and 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 13 relevant studies were included in this review, including 405 eyes in the experimental group (SML combined with anti-VEGF drugs intravitreal injections) and 400 eyes in the control group (anti-VEGF drugs monotherapy). The results showed no significant difference in ETDRS visual acuity between the two groups at any time point (P &amp;gt; 0.05). However, LogMAR visual acuity significantly improved in the experimental group compared to controls at both 6 and 12 months post-treatment (P &amp;lt; 0.05). Subgroup analysis based on baseline CMT values indicated that patients with baseline CMT &amp;lt; 400 \u00b5m had significantly more reduced CMT across all observation points in the experimental group (P &amp;lt; 0.05). Conversely, no significant differences in CMT were found among those with baseline CMT \u2265 400 \u00b5m (P &amp;gt; 0.05). Additionally, annual intravitreal injection frequency of anti-VEGF drugs was significantly reduced in the experimental group compared to the controls (P &amp;lt; 0.05). The average numbers of SML applications per year ranged from 1.41 \u00b1 0.37 to 3.4 \u00b1 1.4 times (range: 1\u20134 times). Common postoperative complications included mild subconjunctival hemorrhage, a light ocular inflammatory reaction, and\/or ocular surface discomfort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared to anti-VEGF drugs monotherapy, combining SML with anti-VEGF drugs can improve visual acuity and reduce macular edema among DME patients\u2014especially those with central macular thickness &amp;lt; 400 \u00b5m. The combined approach also reduces anti-VEGF drugs intravitreal injection frequency, and repeated use of SML can alleviate economic burdens on patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:uri>https:\/\/inplasy.com<\/jats:uri>\n                      , identifier INPLASY2024120068.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2025.1553311","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T01:34:04Z","timestamp":1743125644000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Evaluating the efficacy of subthreshold micropulse laser combined with anti-VEGF drugs in the treatment of diabetic macular edema: a systematic review and 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